Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Collateral Ligaments”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2003

The healing medial collateral ligament following a combined anterior cruciate and medial collateral ligament injury--a biomechanical study in a goat model.

The ideal treatment of a combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injury to the knee is still debated. In particular, the question of whether reconstruction of the ACL can provide the knee with sufficient multidirectional stability to allow for effective MCL healing needs to be better elucidated. Therefore, the first objective of this study was to quantify the changes in the function of goat knees between time-zero and 6 weeks following a combined ACL/MCL injury treated with ACL reconstruction. Using a robotic/universal force-moment sensor testing system, the kinematics of the knee and in situ forces in the ACL/ACL graft as well as in the sham-operated and healing MCL were evaluated in response to (1) a 67 N anterior-posterior (A-P) tibial load and (2) a 5 Nm varus-valgus (V-V) moment. The second objective was to evaluate the structural properties of the healing femur-MCL-tibia complex (FMTC) and the mechanical properties of the healing MCL at 6 weeks under uniaxial tension. In response to the 67 N A-P tibial load, the A-P translations for the experimental knee increased by as much as 4.5 times from time-zero to 6 weeks (p<0.05). Correspondingly, the in situ forces in the ACL graft decreased by as much as 45% (p<0.05). There was no measurable changes of the in situ force in the healing MCL. In response to a 5 Nm V-V moment, V-V rotations were twice as much as controls, but similar for both time periods. From time-zero to 6 weeks, the in situ forces in the ACL graft dropped by over 71% (p<0.05), while the in situ force in the healing MCL was as much as 35+/-19 N. In terms of the structural properties of the healing FMTC, the stiffness and ultimate load values at 6 weeks reached 53% and 29% of sham-operated contralateral controls, respectively (p<0.05). For the mechanical properties of the healing MCL substance, the values for tangent modulus and tensile strength were only 13% and 10% of sham-operated controls, respectively (p<0.05). These results suggest that the ACL graft stabilized the knee initially, but became loose over time. As a result, the healing MCL may have been required to take on excessive loads and was unable to heal sufficiently as compared to an isolated MCL injury.

Animals↗
PubMed1996

Characterization of a large chondroitin sulfate proteoglycan present in bovine collateral ligament.

Bovine collateral ligament synthesized a 35S-labeled large proteoglycan species which eluted with a Kav of approximately 0.27 on Sepharose CL-2B and contained only chondroitin sulfate chains with a molecular mass of approximately 32 kDa. Fluorography of the 35S-labeled core proteins derived from the large ligament proteoglycan revealed a broad range of molecular masses above approximately 200 kDa, which was of comparable size to the four major endogenous core protein bands derived from this proteoglycan detected with 5/6/3-B-3, an antibody directed against terminal unsaturated chondroitin-6-sulfate disaccharides. The core proteins derived from the large ligament proteoglycan exhibited immunoreactivity of 12/21/1-C-6, an antibody specific for a peptide epitope common to both the G1 and G2 domains of aggrecan. Four major core protein bands with molecular masses greater than approximately 200 kDa derived from the large ligament proteoglycan, were detected using the antibodies raised against versican from bovine aorta or human fibroblasts. Compared with aggrecan, the 35S-labeled large ligament proteoglycan was distributed over a broader range of buoyant densities in an associative caesium chloride density gradient. This polydispersity may be indicative of differences in the degree of glycosylation as well as heterogeneity in the size of the large ligament proteoglycan core proteins. The 35S-labeled large ligament proteoglycan also demonstrated the ability to form complexes with an aggrecan aggregate preparation, the majority of which could not be dissociated by the presence of HA10-50. These findings indicate that the large chondrotin sulfate proteoglycan synthesized by bovine collateral ligament may be a versican-like proteoglycan which exhibited the potential to form like protein-stabilized complexes.

Aggrecans↗
PubMed1992

[Combined injury of the anterior cruciate ligament and the medial collateral ligament of the knee joint--results of two to six years follow-up of surgical treatment].

A retrospective study of 148 combined acute knee injuries with anterior cruciate and medial collateral ligament injuries was performed. Follow-up included 115 patients, 95 of whom were personally examined two to six years postoperatively. Proximal anterior cruciate ligament ruptures were treated with reinsertion in 96 patients, in case of intraligamentous lesions (44 times), augmentation with the semitendinosus tendon was performed. Medial collateral ligament lesions were explored during the operation. Reconstruction of intraligamentous ruptures was performed with sutures (120 times). Distal lesions were refixed with Burri plate or staple. A modified Ellison procedure was routinely performed. Postoperative treatment was cast-free and included immediate physiotherapy using a functional brace. Between the two groups with anterior cruciate ligament reinsertion and augmentation, no significant differences were observed in subjective evaluation (Lysholm score 85 vs. 88), activity level (Tegner score 5.5 vs. 5.4) or anterior stability (KT 1000 at 89 N 6.6 vs. 6.1 mm displacement). A clear pivot shift sign was noted in two knees with reinsertion and in none of the augmented group. Medial stability was reestablished almost completely, independent of the site of lesion or the reconstruction technique (average valgus movement at 30 degrees flexion 0.7+ vs. 0.5+ on injured/contralateral side). We conclude that reinsertion of femoral anterior cruciate ligament ruptures will reestablish anterior stability in most cases, although semitendinosus augmentation appears to give slightly more reliable results. Medial stability is gained by the site-depending reconstruction techniques. Whether intraligamentous medial collateral ligament lesions can be left alone with only the anterior cruciate ligament being reconstructed, cannot be answered by this study.

Adolescent↗
PubMed1986

[Biomechanical studies of the ligaments of the knee joint (anterior cruciate ligament and medial collateral ligament) using amputated limbs].

In order to study the biomechanical behavior of the ligaments around the knee joint (anterior cruciate ligament-ACL and medial collateral ligament-MCL), experiments were carried out using ten human amputated specimens. Specially designed small omega-shaped transducers were attached on the selected surface of the ligaments, and elongation of the ligaments were measured under valgus or anterior drawer stress in various flexion or rotation of the joint which was made by specific jig sets. The results showed that the load-elongation response varied depending on the sites of the ligaments and that the anterior instability caused by transection of the ACL gave definite effect on the strain behavior of the MCL and, vice versa, the medial instability caused by transection of the MCL gave considerable effect on that of the ACL. This experiment demonstrated a quantitative relationship between these ligaments which suggests the clinical importance of these ligaments for the knee joint stability.

Animals↗
PubMed1994

An in vitro assay of anterior cruciate ligament (ACL) and medial collateral ligament (MCL) cell migration.

Explants from rabbit anterior cruciate ligaments (ACL) and medial collateral ligaments (MCL) were utilized to compare the relative rates that fibroblasts migrate onto glass and plastic culture surfaces in vitro. During the first two weeks in culture, a monolayer of cells appeared on the periphery of all the ACL and MCL explants. From 45 to 134 hrs in culture, the mean total MCL cell count per explant was 6-12 times greater than that for the ACL on the plastic culture dishes, and this difference was even greater for the cells attached to the glass cover slides over the explants. These differences were significant at the p < .005 level. The rates of cell proliferation were quite similar for primary cultures of ACL and MCL grown in the same medium as that used for the migration assay. The large difference in cell number at early times of culture is thus due to the more rapid MCL cell migration out of the explants, and not to a difference in the rate of cell proliferation. These data support the hypothesis that differences in cell migration rate play a role in the greater healing capacity of the MCL as compared with the ACL. The assay described in this work may then be useful in assessing factors that promote wound healing.

Animals↗
PubMed1990

The effects of transection of the anterior cruciate ligament on healing of the medial collateral ligament. A biomechanical study of the knee in dogs.

The effect of concurrent injury to the anterior cruciate ligament on the healing of injuries of the medial collateral ligament was studied in dogs. In Group I, isolated transection of the medial collateral ligament was performed; in Group II, transection of the medial collateral ligament with partial transection of the anterior cruciate ligament; and in Group III, complete transection of both the medial collateral ligament and the anterior cruciate ligament. The three groups of animals were examined six and twelve weeks postoperatively with respect to varus-valgus rotation of the knee and tensile properties of the femur-medial collateral ligament-tibia complex. The varus-valgus rotation of the knee was found to be the largest in Group-III specimens at all time-periods and was 3.5 times greater than the control values at twelve weeks. Group-I and Group-II specimens also showed large varus-valgus rotations at time zero, but the rotations returned to the control values by twelve weeks. For the structural properties of the femur-medial collateral ligament-tibia complex, the values for ultimate load for Groups I and II reached the control values by twelve weeks, while that for Group III remained at only 80 per cent of the control value. Both energy absorbed at failure and linear stiffness for all three groups were less than those for the controls at six weeks, and only linear stiffness returned to the control values by twelve weeks. For the mechanical (material) properties of the healed ligament substance, the values for modulus and tensile strength were markedly lower than the control values for all groups at six weeks. By twelve weeks, the tensile strength of Group-I specimens had increased to 52 per cent of the control value, while those of Groups II and III were only 45 and 14 per cent, respectively. Our results demonstrate that healing of the transected medial collateral ligament is adversely affected by concomitant transection of the anterior cruciate ligament. Both varus-valgus rotation and mechanical properties of the healed ligament failed to recover in knees that had combined transection of the anterior cruciate and medial collateral ligaments. The structural properties of the femur-medial collateral ligament-tibia complex in tension recovered more rapidly as a consequence of the large mass of reparative tissue that formed in the medial collateral ligament of the anterior cruciate-deficient knees.

Animals↗
PubMed1994

Abnormality of the contralateral ligament after injuries of the medial collateral ligament. An experimental study in rabbits.

The right medial collateral ligament of ninety-four adult, female rabbits was transected operatively. At three, six, fourteen, or forty weeks after the operation, the uninjured, contralateral (left) medial collateral ligaments of seventy-eight of the animals were tested biomechanically and compared with the left medial collateral ligaments of thirty-three normal female rabbits. The diameters of the mid-substance collagen fibrils in the medial collateral ligaments were also measured in the uninjured, contralateral hindlimbs of four animals at each interval and compared with the fibril diameters in three normal animals at each of three corresponding intervals. Subtle but significant differences between the uninjured, contralateral and the normal medial collateral ligaments with regard to biomechanical properties of collagen fibril diameters were found at all time-intervals. These results support the notion of a significant effect on the contralateral ligament after an injury to the medial collateral ligament and suggest that contralateral ligaments cannot be considered as a normal control group even in this relatively benign model of knee injury.

Analysis of Variance↗
PubMed1998

Quantitative evaluation of nutritional pathways for the posterior cruciate ligament and the lateral collateral ligament in rabbits.

The cruciate ligament of the knee receives its nutrition from a direct vascular supply and by permeation of nutrients from the synovial fluid. The contributions of these two routes as nutritional pathways are not known in detail. In this study, we injected [3H]methyl glucose as a tracer intravenously or directly into the knee of rabbits. Tracer concentrations in plasma, synovial fluid, the posterior cruciate ligament (PCL), and the lateral collateral ligament (LCL) were analysed by a pharmacokinetic compartment model. The contribution of [3H]methyl glucose permeation from the synovial fluid during steady state was calculated at 44.3% in the PCL and at 39.0% in the LCL. Although these results indicated that more than half the nutrition for both ligaments is provided by its vascular supply, synovial fluid permeation is also an important transport route for small molecules for the PCL and the LCL, which is an extra-articular structure.

Animals↗
PubMed2001

Roles of the anterior cruciate ligament and the medial collateral ligament in preventing valgus instability.

Both the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL) are reported to prevent valgus instability of the knee. In this study, the anatomical mechanisms by which these ligaments prevent valgus instability were experimentally investigated. The valgus rotation angle and the magnitude of the medial joint space opening were measured in six cadaveric knees, using biplanar photography before and after the MCL and/or the ACL were severed. A significant increase in the valgus rotation angle and a large medial joint space opening were observed when the MCL was severed. An increase in the valgus rotation angle was also observed when the ACL was severed, but only a small medial joint space opening was present. The increase in the valgus rotation angle after ACL severance was nearly parallel to the increase in the internal rotation of the tibia. Thus, we concluded that both ligaments function to prevent valgus instability, but that the anatomical reasons for their function are different. The MCL prevents valgus instability by stopping an opening in the medial joint space. The ACL, on the other hand, prevents the internal rotation of the tibia. When the ACL is severed, the internal rotation increases, and causes the valgus rotation angle to also increase, despite the presence of only a small medial joint space opening.

Adult↗
PubMed2001

Arthroscopic-assisted simultaneous reconstruction of the posterior cruciate ligament and the lateral collateral ligament using hamstrings and absorbable screws.

Arthroscopic-assisted simultaneous reconstruction of the posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL) using hamstring tendon grafts is described. The femoral tunnel is drilled through an incision over the medial femoral condyle and the tibial tunnel through the same skin incision used for harvesting the tendon graft. PCL reconstruction is performed using a 4-strand hamstring tendon graft and absorbable screw fixation. The tendon of the semitendinosus muscle of the uninvolved knee is used as a lateral loop for LCL reconstruction. After pulling the transplant through the fibular head, femoral fixation of the loop is made with an absorbable screw.

Absorbable Implants↗
PubMed2000

Simultaneous avulsion fracture of the insertion of the ulnar and radial collateral ligaments of the metacarpophalangeal joint of the thumb.

We present a case of simultaneous avulsion fracture of the insertion on the volar base of the proximal phalanx of the ulnar and radial collateral ligaments of the metacarpophalangeal joint of the thumb. To our knowledge this combination has never been published before. The mechanism of this injury is not clearly understood. (c) 2000 Harcourt Publishers Ltd Copyright 2000 The British Association of Plastic Surgeons DOI: 10.1054/bjps.1999.3227.

Journal Article↗
PubMed1986

Ligamentous avulsion of the ulnar collateral ligament of the thumb of a child.

Ulnar collateral ligament ruptures of the metacarpophalangeal joint of the thumb in children are usually associated with epiphyseal fractures of the proximal phalanx and, less frequently, cartilaginous fragments from the metacarpal. Radiographs are often normal. We describe an isolated ligamentous avulsion of the ulnar collateral ligament from the thumb metacarpal, without a bony or cartilaginous fragment, in a skeletally immature 12-year-old boy.

Child↗
PubMedDate not supplied

The functional relationship of the posterior oblique ligament to the medial collateral ligament of the human knee.

Strain in the human knee medial collateral ligament (MCL) was measured in cadavers with a Hall effect strain transducer during normal passive knee flexion, as well as knee flexion accompanied by applied external tibial rotation and valgus torques. In an attempt to determine the contribution of the posterior oblique ligament (POL) to the strain behavior of the MCL, the POL was systematically separated from the MCL and changes in strain in the MCL were observed. These changes in strain were mild and variable, except in the one knee which was later found to be lacking an anterior cruciate ligament. In that particular knee, strain in the MCL increased up to 9.97% under the influence of a valgus torque once the POL fibers had been separated from the MCL. Anatomical dissection and transillumination techniques of the MCL/POL complex demonstrated definite ligament fibers connecting the MCL to the POL. The results demonstrate an intimate anatomical relationship between the POL and MCL. However, the POL and MCL appear to work independently from each other according to our test method.

Biomechanical Phenomena↗
PubMed1993

[Skier's thumb--osseous injury and rupture of the ulnar collateral ligament].

Injuries to the ulnar collateral ligament of the thumb are common in down hill-skiing, and are thus called "skier's thumb". In complete disruption of the ligament, surgical treatment is mandatory to restore stability. The management gets more difficult if a bony lesion is present: does a non-displaced fragment represent a non-displaced bony avulsion of the ulnar collateral ligament, thus allowing conservative treatment? We reviewed sixty-three consecutive patients with an acute skier's thumb injury in order to determine the anatomical nature of injuries in thumbs that were treated surgically either for fracture or for instability. Of all 63 thumbs, twenty-five (40%) had a fracture. Surgical exploration showed two types of fractures: a fragment attached to the ulnar collateral ligament, and a fragment not attached to the ulnar collateral ligament. The first type, corresponding to a true avulsion fracture of the ulnar collateral ligament, was found in eight cases. The same fracture type was seen in other seven cases with an additional isolated fragment not attached to the ligament. Such an isolated fragment was observed in ten other cases where the ulnar collateral ligament was completely disrupted. This type of bone fragmentation cannot be differentiated from a bony avulsion of the ulnar collateral ligament on routine films. Therefore, it is mandatory to stress test the injured thumb even when a bony avulsion fracture with no or minimal displacement is suspected on X-ray. The fracture may not represent a bony avulsion, but a fragmentation of the ulnar volar aspect of the proximal phalanx associated with a complete disruption of the ulnar collateral ligament.

Adolescent↗
PubMed2006

The effect of anterior cruciate ligament deficiency on the in vivo elongation of the medial and lateral collateral ligaments.

BACKGROUND: Although anterior cruciate ligament deficiency has been shown to lead to joint degeneration, few quantitative data have been reported on its effect on soft tissue structures surrounding the knee joint. HYPOTHESIS: Anterior cruciate ligament deficiency will alter the deformation of both collateral ligaments during in vivo weight-bearing knee function from 0 degrees to 90 degrees. STUDY DESIGN: Controlled laboratory study. METHODS: Six patients who had acute anterior cruciate ligament injury in 1 knee with the contralateral side intact participated in this study. Using magnetic resonance and dual orthogonal fluoroscopic imaging techniques, we measured the length of the fiber bundles of the superficial medial collateral ligament, deep medial collateral ligament, and lateral collateral ligament of the 6 patients; the healthy contralateral knee of each patient served as a control. RESULTS: Anterior cruciate ligament injury caused a significant elongation of the fiber bundles of the superficial and deep medial collateral ligament at every flexion angle. In contrast, the lateral collateral ligament fiber bundles shortened after anterior cruciate ligament injury. CONCLUSION: The altered deformations of the collateral ligaments associated with the changes in tibiofemoral joint kinematics after anterior cruciate ligament injury demonstrate that deficiency of 1 of the knee joint structures upsets the in vivo knee homeostasis. CLINICAL RELEVANCE: Restoring normal knee kinematics after anterior cruciate ligament reconstruction is critical to restore the normal function of the collateral ligaments.

Adult↗
PubMedDate not supplied

Single-strand ligament reconstruction of the medial collateral ligament restores valgus elbow stability.

The purpose of this study was to determine the contribution of the central portion of the anterior bundle of the medial collateral ligament (MCL) to elbow stability and to evaluate the effectiveness of a single-strand MCL reconstruction in restoring elbow stability. Testing of 11 fresh-frozen upper extremities was first performed on the intact elbow and then with the capsule, flexor-pronator muscle group, posterior bundle, anterior or posterior band, and central band cut sequentially. Next, a single-strand reconstruction of the MCL was performed. The elbow was moved passively through a full arc of flexion in both varus and valgus gravity-loaded positions. Ulnar movement with respect to the humerus was analyzed by means of an electromagnetic tracking system. Maximum varus-valgus laxity throughout the arc of supinated flexion and pronated flexion was 6.6 degree plus minus 2.4 degree and 7.4 degree plus minus 2.0 degree, respectively, for the intact specimen, 34.2 degree plus minus 5.6 degree and 37.7 degree plus minus 11.8 degree for the specimen with all of the medial valgus elbow stabilizers cut, and 9.0 degree plus minus 2.5 degree and 10.5 degree plus minus 2.7 degree for the reconstructed specimen. Maximum varus-valgus laxity was not significantly different among any of the sectioning sequences until the central band was cut (P <.0001). There was no significant difference in maximum varus-valgus laxity between the intact and reconstructed elbows (P <.05). Our results demonstrate that the central band is an important valgus stabilizer of the elbow and that a simplified single-strand reconstruction is able to restore stability to the MCL-deficient elbow.

Aged↗
PubMed2006

Erratum to "The change in length of the medial and lateral collateral ligaments during in vivo knee flexion".

The collateral ligaments of the knee are important in maintaining knee stability. However, little data has been reported on the in vivo function of the collateral ligaments. The objective of this study was to investigate the change in length of different fiber bundles of the medial collateral ligament (MCL), deep fibers of the MCL (DMCL) and the lateral collateral ligament (LCL) during in vivo knee flexion. The knees of five healthy subjects were scanned using magnetic resonance imaging. These images were used to create three-dimensional models of the tibia and femur, including the insertions of the collateral ligaments. The MCL, DMCL, and LCL were each divided into three equal portions: an anterior bundle, a middle bundle and a posterior bundle. Next, the subjects were imaged from two orthogonal directions using fluoroscopy while performing a quasi-static lunge from 0 degrees to 90 degrees of flexion. The models and fluoroscopic images were then used to reproduce the in vivo motion of the knee. From these models, the length of each bundle of each ligament was measured as a function of flexion. The length of the anterior bundle of the MCL did not change significantly with flexion. The length of the posterior bundle of the MCL consistently decreased with flexion (p < 0.05). The change in length of the DMCL with flexion was similar to the trend observed for the MCL. The length of the anterior bundle of the LCL increased with flexion and the length of the posterior bundle decreased with flexion. These data indicate that the collateral ligaments do not elongate uniformly as the knee is flexed, with different bundles becoming taut and slack. These data may help to provide a better understanding of the in vivo function of the collateral ligaments and be used to improve surgical reconstructions of the collateral ligaments. Furthermore, the data suggest that the different roles of various portions of the collateral ligaments along the flexion path should be considered before releasing the collateral ligaments during knee arthroplasty.

Adult↗